Affordable Care Act help available to those in need

Published 12:00 am Saturday, October 19, 2013

By Kimberly Hopson

LAPLACE – River Parishes Hospital in LaPlace is now offering assistance for patients who just can’t sort through many changes on the horizon next year with the implementation of the Affordable Care Act.
The hospital has 15 certified Affordable Care Act counselors available to guide citizens through the sign-up process. According to Michael Mayeux, regional chief financial officer, each counselor must complete a 12-hour class and a rigorous 300-page test before they can be certified. The counselors are trained to answer any questions that might arise from the complicated application but cannot help patients choose a health care plan.
“They can answer questions, and they know where to refer a patients. They also have the ability to assist a patient with applying. We’ve set up a couple of computers in the office, so if the patient wants to sit right there and do it, they can do that,” Mayeux said.
The health care reform law was actually passed in 2010, but changes that will go into effect in January 2014 have thrown it into the spotlight more recently. The law is designed to ensure access to quality, affordable health care coverage and will require most Americans to have some form of health insurance. Insurance providers can no longer deny coverage to those with pre-existing conditions.
An online health care marketplace is designed to provide coverage options for those who do not receive insurance from an employer or are not enrolled in a government operated health care plan, such as Medicaid, Medicare, CHIP or TriCare. Citizens who receive coverage from work or a government program do not need to worry about using the online marketplace. Subsidies are also available to help pay for health insurance premiums for those who earn between 100 and 400 percent of the federal poverty level projected income.
Mayeux also said the counselors cannot print or provide price range estimates for health care premiums because there is so much variation, based on factors such as age, household size and gross income. Prices may also vary by parish, according to Mayeux.
“That’s an open-ended question because it depends. Some parishes have more plans than others. It’s set up so that the insurance companies will rate the premium by parish because there are some parts of the state that have lots of young people, and the premium may be lower. There are some parts of the state where there are lots of older people, therefore your premiums may be higher,” he said. “It’s not real difficult. It’s just complicated. There are a lot of moving parts.”
Thus far, the counselors haven’t had much traffic — approximately seven people have called to ask questions, but no one has shown up in person to make an appointment. Mayeux chalked the lack of appointments up to the notoriously difficult online interface.
“Right now it’s still pretty light. People are having difficulty getting into the system and navigating through it. Ninety-nine-point-nine percent of the people I’ve talked to have no idea whatsoever what this is all about. Now they’re getting into the detail, and folks are going ‘Oh my gosh, this is complicated,’” he said. “It’s my impression that it’s going to be slow, but we are prepared.”
Mayeax went on to say that the Affordable Care Act is expected to have a drastic impact on the hospital. According to his estimates, River Parishes Hospital currently writes off at least $1 million a month to provide care for patients who have no insurance.
“2013 is not going to have much impact because it will be slow picking up, but 2014 to 2015, it’s theorized that it will have a $2 to $3 million impact. What is planned is that the ACA will make coverage available to a lot of these patients. That million a month that i’m writing off, I’ll now be able to recoup a big piece of that,” said Mayeax.
Open enrollment for the online marketplace officially began on Oct. 1. Citizens who wish for their coverage to take effect Jan. 1 must enroll by Dec. 15, although the enrollment period will last until March 31, 2014. Citizens may contact the hospital at 985-652-7000 to make an appointment with a counselor. The application is available online at, by phone at 1-800-318-2596, or on paper for those who do not have Internet access. Customer service representatives are also available 24/7 in more than 150 languages.
River Parishes Hospital also sponsors an informational presentation through the Louisiana Healthcare Education Coalition. To request a presentation, visit